luni, 19 decembrie 2011

Discerning Gift-Givers Look for Toys That Offer More Than Fun

MONDAY, Dec. 19 (HealthDay News) -- When it comes to toys, kids' wish lists for the holiday season often pose a dilemma for parents, who find themselves asking two crucial questions.

The first question is almost knee-jerk: Which of these toys will be safe for my child?

And the second, though not as obvious, is becoming more common in the era of toys and media aimed at spurring a child's development: Which of these toys will be good for my kid?

Common sense can help guide parents to toys that will aid their child's growth, said Dr. Garry Gardner, chairman of the American Academy of Pediatrics' council on injury, violence and poison prevention and a Chicago area pediatrician.

"Two things come to mind," Gardner said. "Kids need toys that are engaging and encourage imaginative and creative play. And kids need toys that encourage activity and exercise."

December has been dubbed Safe Toys and Gifts Month, but many parents these days want to buy gifts that go beyond being harmless and actually are beneficial for kids.

Gardner and Dr. Benjamin Hoffman, a pediatrician at Doernbecher Children's Hospital in Portland, Ore., agreed that one of the best things parents can do is purchase toys that cut down on the amount of their children's "screen time" -- time spent in front of televisions, computers and portable devices.

Video games can help hone a child's fine motor skills, but they also drain time away from more creative or healthy pursuits, Gardner said.

"I've seen kids outside on a beautiful day at the park and here they are, sitting on a bench and playing a video game," he said. "And kids sitting in front of a screen often are snacking -- and not on healthy foods."

What's worse, Hoffman said, is that so much screen input might have detrimental effects on kids' development.

"The cognitive stimulation kids receive from a screen is different, and probably not beneficial," he said. "Our human brains did not evolve to sit in front of a screen with flashing lights and loud sounds. It is potentially harmful to child development."

So what toys are good for kids? Gardner believes parents should begin by keeping it simple.

"Keep in mind, a lot of time kids have more fun with the box than the toy that was inside," he said. "Parents don't need to spend a lot of money, or have a lot of angst whether this is the 'Einstein' toy that's going to make their child brilliant."

Types of toys that allow kids to engage their imaginations and intellects, according to Hoffman and Gardner, include:

Building blocks or Legos.Paints, modeling clays and other art supplies.Puzzles and games that promote logic and reasoning.

Parents also should consider toys that prompt outdoor activity or physical exercise, like bicycles, skates and outdoor play equipment, the two pediatricians said.

"I love the idea of toys that are going to get kids outside, active, running around playing," Hoffman said. "It helps set the stage for kids who remain active later on."

These sorts of gifts require more forethought and vigilance from parents and other gift-buyers, however. They need to make sure they're purchasing age-appropriate gear for kids, along with any helmets and other protective equipment needed for safe use.

"Toys with wheels often are bought prematurely for children," Hoffman said. "Even though they may seem to have the manual dexterity, they don't have the cognitive ability to assess risks."

The same goes for swing sets and other outdoor play equipment, which can pose a falling hazard for kids who are too young, he said.

"If the child is going to play with these items, there needs to be an adult there to supervise, depending on their age," Hoffman said. "A 10-year-old on a bicycle on a closed street in a neighborhood is completely appropriate. Sending a 4-year-old out on the street is not."

Hoffman noted that there's another type of gift that's important for kids but often is overlooked because it doesn't seem as "fun" as other options.

"Parents often forget about the impact that reading and books have on children," he said. "That's one of the best things a kid can get." He urged parents interested in their child's development to be sure to give books as gifts.

In terms of toy safety, Gardner and Hoffman emphasized a few key points:

Keep choking hazards in mind, particularly for young children and with toys that have small parts. Use a toilet paper tube as a guide: If a piece can fit through the tube, the toy isn't appropriate for small children.Be careful when giving toys that contain small magnets. If more than one is swallowed, the magnets can stick together in the digestive tract and cause tearing of the bowel wall, Gardner said.Toys that shoot missiles or other objects are prime hazards for eye injuries.Be aware that costume jewelry and other low-cost toys can contain lead, particularly if they are imported from another country.Toys with small batteries also should be approached with caution. Tiny lithium batteries can be swallowed and lodge in the esophagus, where they pass a current through the moist membranes. "It actually burns a hole through the esophagus in a two-hour time frame," Gardner said.

More information

To learn more about choosing safe toys, visit the Nemours Foundation.

To read a toy expert's advice for selecting a gift, click here.


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Health Tip: Skip the Cold Medicine Before Age 4

Federal health officials said Monday they have added new safety warnings to the heart rhythm drug Multaq, after a company study by Sanofi linked the tablet to higher rates of heart attack, stroke and death in a subset of patients.


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Opting to track, not treat, early prostate cancer

WASHINGTON (AP) — John Shoemaker visited six doctors in his quest to find the best treatment for his early stage prostate cancer — and only the last one offered what made the most sense to the California man: Keep a close watch on the tumor and treat only if it starts to grow.

Very few men choose this active surveillance option. Yet Shoemaker is one of more than 100,000 men a year deemed candidates for it by a government panel. That's because their prostate cancer carries such a low risk of morphing into the kind that could kill.

The risk for them is so low, in fact, that specialists convened recently by the National Institutes of Health say it's time to strip the name "cancer" off these small, lazy tumors.

In the meantime, the panel wants more of those men offered the option of delaying treatment until regular check-ups show it's really needed. That endorsement promises to fuel efforts by the Prostate Cancer Foundation and a few other groups to spread the word to the newly diagnosed.

Shoemaker's journey shows how difficult that may be, from doctors who don't even bring it up to the fear factor.

"With prostate cancer, you hear the "C'' word, so to speak, and people freak out," says Shoemaker, 69, a businessman from Los Altos, Calif., who was intent on examining all his options.

Five years after his diagnosis — and five biopsies plus numerous blood tests and ultrasound scans later — Shoemaker's happy he found a surgeon who argued against immediate treatment. He's confident his prostate tumor hasn't grown, and avoided the pain and side effects of surgery or radiation.

Some 240,000 men a year in the U.S. are diagnosed with prostate cancer. Earlier this month, the NIH-appointed panel found that most have the low-risk kind, a legacy of using problematic PSA blood tests to screen healthy men for possible signs of this slow-growing cancer that will affect most men's prostates if they live long enough.

Yet 90 percent of such men choose immediate treatment such as surgery or radiation, risking serious and long-lasting side effects, such as impotence or incontinence, without good evidence about who will live longer as a result. One recent study tracked 731 men diagnosed with early stage prostate cancer for 10 years and found no difference in survival between those who had surgery and those who weren't treated unless they went on to develop cancer symptoms, an older option known as watchful waiting.

Active surveillance is much more aggressive than watchful waiting — men get regular scans, blood tests and biopsies to check the tumor, although the NIH panel found the degree of monitoring can vary by medical center. Active surveillance is designed to monitor men closely enough that they can get curative treatment quickly if it looks like they'll need it, well before any symptoms would begin.

"It's not treatment versus no treatment; it's about timing of treatment," Shoemaker's physician, Dr. Peter Carroll of the University of California, San Francisco, told the NIH. He's a well-known prostate cancer surgeon who also leads one of the country's few large active-surveillance programs, tracking more than 900 men for over five years. Most are treatment-free so far, and none has gone on to die of prostate cancer.

What's the advice for men? The NIH panel said men with a PSA level less than 10 and a Gleason score that's 6 or less are candidates for this type of active surveillance. The Gleason score measures how aggressive prostate cancer cells look under the microscope. Urologists can provide those numbers.

Then what? Today, what men decide to do next largely depends on the advice of the specialist they wind up seeing, and many either don't offer active surveillance or present it in a negative way, as doing nothing, the NIH panel learned. There's also the patient's instinctive "get it out" reaction.

Enter the National Proactive Surveillance Network — at http://www.npsn.net — a collaboration of two large active-surveillance programs, at Johns Hopkins University and Cedars-Sinai Medical Center, with the Prostate Cancer Foundation. First, it aims to educate men about active surveillance.

Within a few months, an interactive section of the site will be added to link men with doctors who offer active surveillance and track how they fare with input straight from the patients themselves, said Hopkins' Dr. H. Ballentine Carter.

"To me, it's an individualized approach rather than the one-size-fits-all approach of treating everyone," Carter says.

Beyond whether and how men choose surveillance, behavioral scientist Kathryn Taylor of Georgetown University wants to know how they decide to stick with it. About a quarter of men abandon the observation approach within two or three years, and as many as half by five years, the NIH panel learned. It's not clear how much of that was because they needed treatment, and how much was just the anxiety or getting tired of repeat biopsies.

Taylor is beginning a study of 1,500 newly diagnosed, low-risk prostate cancer patients at Kaiser Permanente in Northern California to see how many are told about active surveillance and what helped or hindered their decision.

"Living with untreated cancer is very difficult," she says, "and not everybody can do it, not surprisingly."

___

EDITOR'S NOTE — Lauran Neergaard covers health and medical issues for The Associated Press.


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US issues warning to unconventional sperm donor

SAN FRANCISCO (AP) — A man from the San Francisco Bay area has fathered 14 children in the last five years through free sperm donations to women he meets through his website — and is now in trouble with the federal government.

The case of Trent Arsenault has drawn attention to the practice of informal sperm donation, which physicians and bioethicists call unsafe but some people say is a civil liberties issue.

Arsenault says he donates sperm out of a sense of service to help people who want to have children but can't afford conventional sperm banks. The 36-year-old minister's son has four more children on the way.

"I always had known through people praying at church that there's fertility issues," Arsenault told The Associated Press on Monday. "I thought it would just be a neat way of service to help the community."

The U.S. Food and Drug Administration sent Arsenault a cease-and-desist letter late last year telling him he must stop because he does not follow the agency's requirements for getting tested for sexually transmitted diseases within seven days before giving sperm. The FDA did not immediately respond to requests for comment.

Violators of FDA regulations on human cells and tissues face up to a year in prison and a $100,000 fine, according to guidelines published on the agency's website.

Arsenault gets tested regularly, but following the FDA's rules would make it impossible to keep offering his sperm for free, he said.

"The regulations may be little bit strict, but I think that's appropriate," said Dr. Mitchell Rosen, director of the University of California, San Francisco Fertility Preservation Center.

Rosen said it's not uncommon for women to use donated sperm from someone they know. But trusting a donor who is being honest about his background is no substitute for screening for diseases that could be passed on to the mother or child, he said.

A sperm bank will also isolate the actual sperm cells from the donor's semen, which reduces the risk of passing along pathogens, Rosen said. "In this situation there's no reduction of risk. It's just as if they're going out and having a one-night stand."

Arsenault believes the FDA tracked him down from his website, which advertises his availability as a sperm donor. While some men offer their sperm through anonymous ads on Craigslist, Arsenault's site is filled with photographs of the trim, blond Midwest native. In its letter, the agency describes Arsenault's service as a business. Arsenault disagrees.

"This is not a business or a clinic. It's just people partnering up to have a baby out of compassion," he said.

At the time of the FDA letter, the Silicon Valley computer security specialist had made 328 sperm donations to 46 women, a number he said is now higher. He can continue to donate sperm while the case is pending.

Experts say the volume of sperm donations by Arsenault creates risks for future generations. They say the greater the number of children, the greater the chances of spreading a genetic defect. Children who don't know they're related could also unwittingly have sex, though unlike the anonymous sperm donor system used by sperm banks, Arsenault keeps careful track of his offspring.

"There's a danger of accidental incest or inbreeding if you're the father of 14 children" and a habitual sperm donor, said bioethicist Arthur Caplan at University of Pennsylvania. "Nobody should be involved as a sperm donor on that level. It's not safe."

Caplan said the FDA may have a tough time asserting its authority over this kind of informal activity, though. Other medical experts think the agency may have a case since it deals with the safety of public health.

"He should not be allowed to do it unless he gets himself tested" and follow the same rules as sperm banks, said Dr. Stanley Korenman, associate dean of ethics at the UCLA David Geffen School of Medicine.

The difference between asking a friend to donate sperm and the San Francisco case is a matter of volume, experts says.

"This guy is doing it commercially. He's turning out a lot of babies. If you have a friend doing it once or twice it's not a big deal," Korenman said.

The oldest child Arsenault has fathered is now 4. He and the recipients, whom he describes as "intimate partners," sign a legal agreement ahead of time stripping him of any custody rights and absolving him of any financial responsibility for the children.

But he says that part of the reason of making himself publicly visible as a sperm donor rather than remaining anonymous, as is typical with sperm banks, is because he and some of the families hope and expect he will have some involvement in the children's lives in the future.

He says he believes his case comes down to constitutional issues of a right to privacy and reproductive choice.

"It's not that much more different than a couple knowing each other who want to have a baby," Arsenault said. "It's just from me it comes in a cup versus sex."

___

Associated Press science writer Alicia Chang in Los Angeles and writer Terence Chea in San Francisco contributed to this report.

___

Marcus Wohlsen can be reached on Twitter: http://twitter.com/marcuswohlsen


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Health Tip: Are You at Risk for Macular Degeneration?

Federal health officials said Monday they have added new safety warnings to the heart rhythm drug Multaq, after a company study by Sanofi linked the tablet to higher rates of heart attack, stroke and death in a subset of patients.


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US regulators warn of heart risks of Sanofi's Multaq

Federal health officials said Monday they have added new safety warnings to the heart rhythm drug Multaq, after a company study by Sanofi linked the tablet to higher rates of heart attack, stroke and death in a subset of patients.


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Health Highlights: Dec. 19, 2011

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Chickenpox Stymied by Sunlight: Study

Sunlight may help prevent the spread of chickenpox, a new study says.

U.K. researchers compared the findings of 25 previous studies conducted worldwide with climate data and determined that chickenpox is less common in areas with high ultraviolet light levels, BBC News reported.

This suggests that sunlight may inactivate the chickenpox (varicella-zoster) virus on the skin, making transmission between people more difficult.

The University of London researchers noted that the finding may explain why chickenpox is less common in and less easily passed from person to person in tropical countries, BBC News reported.

The study appears in the journal Virology.

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Organic Celery Seed Recalled

The threat of potential salmonella contamination has led to the recall of organic celery seed distributed by Swanson Health Products.

The company was told about the potential contamination by its supplier, B&M Inc. of Mount Vernon, Mo., the Associated Press reported.

The recall involves Swanson Organic Celery Seed (Whole) packaged in plastic bottles with a net weight of 1.4 ounces. They were sold between June 16 and Dec. 16.

The celery seed was sold at Swanson Health Products' retail store in Fargo, N.D., held for pickup at the company's headquarters, or shipped directly to online or mail-order customers, the AP reported.

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Sperm Donor Warned by FDA

A California man who has been donating his sperm to women who want children has been told to stop by the U.S. Food and Drug Administration.

Trent Arsenault, 36, told the San Francisco Chronicle that he's been donating cups of his sperm for five years to women he meets on the Internet, the Associated Press reported.

He said he decided against donating to sperm banks, which offer money and donor anonymity, because he wanted to meet the future parents. So far, he's fathered 14 children.

The FDA told Arsenault he faces a $100,000 fine or up to a year in prison for violating federal laws that require screening for communicable diseases, the AP reported.

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Tyson Fresh Meats Recalls Ground Beef

A positive test for E. coli has led to the recall of more than 40,000 pounds of ground beef products distributed by Tyson Fresh Meats Inc. of Dakota City, Neb.

The recall involves 10-pound chubs of chuck fine ground beef 80/20 packed in cases containing eight chubs. The meat was shipped to distributors and institutions in Alabama, California, Florida, Georgia, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New York, North Carolina, Ohio, South Carolina, Tennessee, West Virginia, and Wisconsin, the Associated Press reported.

The E. coli was discovered through routine monitoring, according to the U.S. Department of Agriculture's Food Safety and Inspection Service. There have not been any reported cases of illness.

The USDA said consumers can call Tyson Fresh Meats at 866-328-3156, the AP reported.

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States Allowed to Determine Essential Health Insurance Benefits

The new U.S. health care law will allow states to specify which health benefits within broad categories must be provided by insurers, the Obama administration said Friday.

The surprise announcement that the federal government will not define a single uniform set of "essential health benefits" means there could be significant variations in benefits from state to state, The New York Times reported.

That would make it similar to the current differences in state Medicaid programs and the Child Health Insurance Program.

The Obama administration's decision was questioned by an expert on health law at Washington and Lee University.

"The new bulletin perpetuates uncertainty about what benefits an insurer will be required to cover under the Affordable Care Act," Prof. Timothy S. Jost told The Times.

For the sake of consumers, he added, "I wish the Department of Health and Human Services had signaled that there would be more uniformity and less flexibility."

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Two People Die After Using Tap Water in Neti Pot

Tap water should not be used in Neti pots, Louisiana officials warned after investigating two deadly infections.

A 20-year-old man and a 51-year-old woman died from Naegleria fowleri infections after using Neti pots containing tap water to flush their sinuses, ABC News reported.

Naegleria fowleri, a parasite sometimes called the brain-eating amoeba, causes a brain infection called primary amoebic meningoencephalitis. Without treatment, the infection can cause death within one to 12 days.

"If you are irrigating, flushing or rinsing your sinuses, for example, by using a Neti pot, use distilled, sterile or previously boiled water to make up the irrigation solution," Louisiana State epidemiologist Dr. Raoult Ratard said in a statement, ABC News reported. "Tap water is safe for drinking but not for irrigating your nose."

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FDA Approves Heart Assist Device for Children

A new mechanical cardiac assist device for children with heart failure has been approved by the U.S. Food and Drug Administration.

The EXCOR Pediatric System is meant to keep children with heart failure alive until they can undergo a heart transplant. The device comes in different sizes to fit children from newborns to teens.

The FDA approved the new device under a Humanitarian Device Exemption. Under this application, a device doesn't have to show a reasonable assurance of effectiveness. Rather, a company has to show that the probable benefit from the device outweighs the problem risk of illness or injury.

"This is a step forward, it is the first FDA-approved pulsatile mechanical circulatory support device specifically designed for children," Dr. Susan Cummins, chief pediatric medical officer in the FDA's Center for Devices and Radiological Health, said in an agency news release. "Previous adult heart assist devices were too large to be used in critically ill children to keep them alive while they wait to get a new heart."

The heart device is made by Berlin Heart of Germany.


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Olympus extends gains, jumps more than 14 percent

(Reuters) - Bank of America Corp shares closed below $5 on Monday for the first time since March 2009 amid continued concern about its need to build capital. The stock closed at $4.99, down 4 percent, after dropping as low as $4.92. The shares have not closed below $5 since March 11, 2009. In recent months, the shares of …


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U.S. says encouraged by Japan beef review

WASHINGTON (Reuters) - U.S. Trade Representative Ron Kirk on Monday welcomed Japan's decision to review its ban on certain cuts of beef from the United States as a sign of Tokyo's interest in joining talks on an Asia Pacific free trade pact.

"I welcome this important step which puts us on a path to address the long-standing issue of beef trade with the United States," Kirk said in a statement after meeting with Japanese Foreign Minister Koichiro Gemba.

Kirk said he urged Japan to further open its market to U.S. beef exports as quickly as possible.

He said he told Gemba that Tokyo must be prepared to tackle a number of other trade barriers if it wants to join talks on the Trans-Pacific Partnership (TPP). Those negotiations now include the United States and eight other countries.

Japan currently bans imports of U.S. beef from cattle older than 20 months, as a result of several cases of mad cow disease found in the U.S. cattle herd about eight years ago.

The United States says it has addressed the threat posed by those cases and that all of its beef now meets international safety standards regardless of the age of the cow.

Senate Finance Committee Chairman Max Baucus, a Montana Democrat whose committee has jurisdiction over trade agreements in Congress, Japan's decision to reassess the risk of importing beef from older U.S. cattle was long overdue.

"As Japan moves forward with its review process, we will be watching closely to ensure its beef policies are based on science and consistent with international standards, so U.S. ranchers can compete on a level playing field," Baucus said.

The United States hopes to finish negotiations on the proposed Trans-Pacific Partnership pact next year, but some trade experts believe the talks could easily extend into 2013.

Japan, Mexico and Canada asked last month to join the talks, which currently include the United States, Australia, New Zealand, Chile, Peru, Singapore, Brunei, Vietnam and Malaysia.

The addition of Japan, the world's second largest economy, would make proposed agreement the world's biggest free trade area if negotiators are successful.

But Tokyo's participation also could make striking a final deal much more difficult.

Japan is the United States's fourth-largest trading partner, with two-way trade last year totaling about $181 billion. But U.S. exporters say they still face many barriers in Japan's agricultural, auto, insurance and other markets.

U.S. lawmakers at a hearing last week on the TPP said they welcomed Japan's joining the negotiations, but only if it is prepared to open up its sensitive sectors.

Kirk said the talks were now on two parallel tracks.

The nine current TPP members are continuing to negotiate among themselves, while consulting separately with Japan, Mexico and Canada on their readiness to join the talks.

The TPP members are expected to make a decision some time next year on whether to formally bring the three applicants into the negotiations.

(Reporting By Doug Palmer; editing by Todd Eastham)


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Vitamin D Helps Bone Health Only With Calcium: Report

MONDAY, Dec. 19 (HealthDay News) -- A new analysis on the effects of vitamin D on bone health shows that it cuts fracture risk in older adults, but only when taken with calcium supplements.

The review of nearly 50 studies on vitamin D -- present in a small number of foods and produced naturally in the skin with sun exposure -- by the U.S. Preventive Services Task Force (USPSTF) also indicates that it's too soon to tell if vitamin D supplements can help prevent cancer.

Report author Mei Chung, assistant director of the Evidence-based Practice Center at Tufts Medical Center in Boston, said she wasn't able to advise specific recommended doses based on the review, which concluded that a daily vitamin D regimen of between 300 and 1,100 international units (IUs) combined with 500 to 1,200 milligrams (mg) of calcium reduces fracture risk in those over 65.

"I think vitamin D likely has more benefits than we currently know and also [presents] little harm," said Dr. Robert Graham, a vitamin D researcher and internist at Lenox Hill Hospital in New York City, who did not participate in the USPSTF report, published Dec. 20 in the Annals of Internal Medicine.

"An acceptable level is always a moving target," Graham added. "It's a very controversial topic, although I honestly don't know why it's so controversial."

The USPSTF review comes about a year after a more extensive report by the Institute of Medicine (IOM), the health arm of the National Academy of Sciences, which said that most Americans and Canadians up to age 70 need no more than 600 IUs of vitamin D per day to maintain health, while those 71 and older may need as much as 800 IUs.

The IOM report took nearly 1,000 published studies into account, while the latest review incorporated 19 randomized controlled trials and 28 observational studies to determine the benefits and harms of vitamin D with or without calcium supplementation on clinical outcomes of cancer and fractures.

In a related study also published in the Annals of Internal Medicine issue, the USPSTF noted that there's still no evidence to support vitamin D supplementation to prevent heart disease. Limited data suggest that high dosages can reduce the risk for all kinds of cancer, but more research is needed to draw a firm conclusion, the USPSTF said. And concern remains about proper dosing, since too much vitamin D can raise the risk for kidney and urinary tract stones.

Graham said most people should ask their doctors to test their blood levels of vitamin D to ensure they're not deficient.

"More physicians are checking vitamin D in their patients," he said. "I think there's greater awareness. At some point we have to decide what's good, what's bad, what's safe and what's not safe. I think we've learned from the last 10 years of this data, that there's still a lot we don't know about vitamin D."

Chung, also an investigator at Tufts Medical Center's Institute for Clinical Research and Health Policy Studies, said that research focusing on bone mineral density -- a measurement of bone thickness -- could be useful to further pin down correct vitamin D doses for various age groups.

"It could be a shorter trial that could enroll many more people . . . and compare a variety of doses to see which dose we could probably use to the best effect," she said. "If we use fracture as an outcome, it will take much longer and cost a lot of money to enroll a lot of subjects."

More information

The U.S. National Library of Medicine has more on vitamin D.


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Fake-tan lotion users tend to stay out of sun: study

(Reuters) - Women who use lotions and gels to produce a fake suntan tend to cut back on outdoor sunbathing and use of tanning beds, with close to 40 percent who use such products saying they limited their time in the sun, U.S. researchers said.

The findings, published in the Archives of Dermatology, mean that the products may be a way to convince women seeking a tan to reduce ultraviolet (UV) radiation exposure, which is linked to a higher risk of skin cancer, the researchers said.

"The message I give is, your natural skin color is where you were born to be, but if you really want to be tan get it out of a bottle," said Suephy Chen, a dermatologist at Emory University School of Medicine in Atlanta, who worked on the study.

"Getting a tan out of a bottle is incredibly safe, whereas getting tanned from tanning beds and lying out is not."

Chen noted that while there's still controversy among skin doctors about whether they should be promoting any tanning product or if the only message should be that natural skin color is best, years of warning about cancer risks from other forms of tanning clearly aren't getting through to younger generations.

The U.S. National Cancer Institute estimated that there were more than 1 million new cases of non-melanoma skin cancer in 2010 in the United States, and fewer than 1,000 deaths. For the more dangerous melanomas, 2011 was expected to see about 70,000 new cases and close to 9,000 deaths.

Researchers surveyed 415 women living on or around the Emory University campus who ranged in age from 18 to 71, but most were under 26. They reported how often they tanned outside or in tanning beds, or used sunless tanners.

About half said they'd used sunless tanning lotions, gels or spray-ons in the past year, and at least 70 percent reported tanning in the sun. One-quarter said they'd recently used a tanning bed.

While women who used tanning products said they were also more likely to seek other types of tans, close to 40 percent said they had decreased their sun exposure or use of tanning beds because of the products.

The top reasons for using sunless tanning products were safety and to avoid wrinkles, the researchers said. Some people with sensitive skin may get a rash, but in general the products are safe.

Daniel Sheehan, a dermatologist at Georgia Health Services University in August, said that some dermatologists might consider it a mixed message to suggest sunless tanning products when patients really shouldn't want to tan at all.

"On the other hand, I don't think that standpoint recognizes the reality that people really want a tanned appearance, and many of them are going to get it one way or another," said Sheehan, who was not involved in the study.

"We're probably better off encouraging people to pursue a safe tan than a UV tan." SOURCE: http://bit.ly/e5SbUW

(Reporting from New York by Genevra Pittman at Reuters Health; Editing by Elaine Lies and Robert Birsel)


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'Nerve Snip' Might Ease Dangerous Irregular Heartbeat

MONDAY, Dec. 19 (HealthDay News) -- Snipping certain nerves may help prevent dangerous heart rhythms caused by stress, a small, new study suggests.

An adrenalin-driven "fight or flight" stress reaction in response to danger is normal, but this reaction is abnormally strong in some people and can lead to excessive sweaty palms (hyperhidrosis) and irregular heart rhythms called ventricular arrhythmias, which originate in the lower chambers of the heart.

Now, a team of cardiologists at the University of California, Los Angeles has found that snipping nerves related to the sympathetic nervous system on both the right and left sides of the chest may help prevent these ventricular arrhythmias, also referred to as "electrical storms."

Ventricular arrhythmia kills 400,000 people in the United States each year and is a leading cause of death in the nation, according to a UCLA Health Sciences news release. Treatments include medications, an implantable cardioverter defibrillator and a procedure called catheter ablation, which provides a targeted burn to the tiny area of the heart that causes the irregular heartbeat.

"When these treatment options fail, especially for a patient experiencing a life-threatening electrical storm, the situation becomes critical. We are always seeking additional options to help patients," senior study author Dr. Kalyanam Shivkumar, director of the UCLA Cardiac Arrhythmia Center and co-director of the Oppenheimer Family Center for Neurobiology of Stress at UCLA, said in the news release.

The new procedure, called a bilateral cardiac sympathetic denervation, was performed on six patients. After the surgery, four of the patients had a complete response and no longer experienced arrhythmias, one patient had a partial response, and one had no response.

One cardiologist said the nerve snip may have a place in caring for arrhythmias.

"Autonomic influences on the cardiac rhythm may be very potent and their subsequent manipulation to aid in rhythm management have been utilized for several years," said Dr. Larry Chinitz, director of the Heart Rhythm Center at NYU Langone Medical Center in New York City. He called the new procedure "an innovative use of this surgical technique and one that may prove to be a potent adjunct to currently available therapies."

The study, which was funded by the U.S. National Institutes of Health, appears in the Dec. 27/Jan.3 issue of the Journal of the American College of Cardiology.

More information

The American Academy of Family Physicians has more about arrhythmias.


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US breakthrough in live cancer cells

US researchers said Monday they have discovered how to keep tumor cells alive in a lab, generating buzz in the scientific community about a potential breakthrough that could transform cancer treatment.

Until now, scientists have been unable to make cancer cells thrive for very long, or in a condition that resembles the way they act in the body. Doctors diagnose and recommend treatment largely based on biopsied tissue that is frozen or set in wax.

The advance has sparked new hope that someday doctors may be able to test a host of cancer-killing drugs on a person's own tumor cells in the lab, before returning to the patient with a therapy that is a proven to be a good match.

"This would really be the ultimate in personalized medicine," said lead author Richard Schlegel, chairman of the department of pathology at Georgetown University's Lombardi Comprehensive Cancer Center.

"The therapies would be exactly from their tissues. We would get normal tissue and tumor tissue from a particular patient and specifically match up their therapies," he told AFP.

"We are really excited about the possibilities of testing we can do with this."

The method, described in the online edition of the American Journal of Pathology, borrows from a simple method used in stem cell research, experts said.

Lung, breast, prostate and colon cancers were kept alive for up to two years using the technique, which combines fibroblast feeder cells to keep cells alive and a Rho kinase (ROCK) inhibitor that allows them to reproduce.

When treated with the duo, both cancer and normal cells reverted to a "stem-like state," Schlegel said, allowing researchers to compare the living cells directly for the first time.

If other scientists can replicate the technique -- and three labs in the United States are already working on it -- the advance could herald a long-awaited transformation in the way cancer cells are studied.

"A tumor from one patient is different from a cancer from another patient, and really that is one important reason why so many clinical trials fail," said Marc Symons, investigator at the Center for Oncology and Cell Biology at The Feinstein Institute for Medical Research in Manhasset, New York.

"I think it is fair to say this revolutionizes the way we think of cancer treatment," added Symons, who was not involved in the study.

Cancer is the leading cause of death in the world, killing 7.6 million people in 2008, according to the latest data from the World Health Organization.


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Pediatricians Offer Tips to Avoid Holiday Hazards

Vietnam says an outbreak of hand, foot and mouth disease has killed 156 people, mostly children, and sickened more than 96,000 through late November.


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Recession Hurting Parent-Child Ties, Survey Finds

THURSDAY, Dec. 15 (HealthDay News) -- The recent recession took a toll on parent-child ties, with parents who were under financial strain reporting that they felt less connected to their kids and kids saying they were less likely to act with generosity, a new study finds.

Researchers from University of Nebraska-Lincoln and Brigham Young University analyzed data from a survey done in 2009 and then again a year later of about 500 families in the Seattle area about their feelings of depression, economic stress and family relationships.

The families were mostly white, middle- to upper-middle-class and college educated. The children were young adolescents, aged 10 to 14.

From one year to the next, parents who reported increasing financial pressure were also more likely to report symptoms of depression, according to the study. In turn, depressed parents were more likely to report feeling less connected and less close with their child.

Likewise, parental financial strain and depression also affected the children. Children whose parents were struggling were less likely to say they volunteered, helped their friends or their families, found enjoyment in doing small favors for others, or tried to cheer up people who were feeling blue -- a group of positive behaviors researchers call "pro-social behaviors."

"The effects of the economic strain are present and having an impact on families that we consider middle-class and upper-middle-class," said lead study author Gustavo Carlo, currently a professor of human development and family studies at the University of Missouri. "These are families you'd think maybe aren't feeling the effects of the economic crisis in the way that other communities are, or that might have access to resources that other families might not have easy access to."

And the families interviewed were from the Seattle area, which wasn't even as hard hit during the downturn as other regions of the country, Carlo added. "One can only imagine how these effects are being felt by families in areas where the communities have really suffered tremendously from the economic situation," he said.

The study appears online and in the December print issue of the Journal of Research on Adolescence.

To be sure, not every parent experiencing economic strain will become anxious and depressed, said Velma McBride Murry, a professor of human and organizational development at Vanderbilt University in Nashville, Tenn.

"If you enter this situation having an increased vulnerability to depression and anxiety, economic strain elevates it, or sets it off to where you are more likely to experience greater devastation than people who are much more mentally stable," Murry said.

But the current study adds to a large body of evidence that cuts across income levels and racial and ethnic groups and shows that economic stress can have a "cascading effect" on the whole family, Murry said. When under financial stress, parents who are used to being able to give their children a cellphone or new clothes suffer mentally when they can no longer do so. As money worries mount -- they're not sure they can pay the mortgage, or the utility bill, or a medical expense that comes in -- parents can become overwhelmed, irritable, short-tempered, depressed and withdrawn.

"Then it erodes communication in the family, and reduces the connectedness that parents have with their children," Murry said.

The kids feel it, too, and their attitudes and behavior can also suffer. Prior research has shown that the kids aren't bothered by the loss of the material goods -- the new cellphone or the clothes -- but by the impact it's having on their family, she added.

"Prior studies have found that kids will say, 'it's not the stuff that I miss. I miss my relationship with my parents. That has shifted and the environment in my family has shifted,'" Murry said.

Parents who are feeling economically strained and depressed should seek out emotional support, whether it's from family and friends, their church or from a mental health professional, Carlo urged.

"They may have to pay some extra attention to work on the quality of the relationship with their child," he said.

More information

The U.S. National Institute of Mental Health has more on depression.


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Dutch pot sales to foreigners go up in smoke

AMSTERDAM (Reuters) - The reputation of the Netherlands as the go-to country for a legal joint will begin to vanish like a puff of smoke next year as sales to foreigners of cannabis and hashish in coffee shops are banned.

The Dutch government has been clamping down on the sale of soft drugs since 2007 because of gang-related crime and concern about the risk to health, particularly as stronger forms of cannabis have been introduced.

"The Dutch drugs policy's appeal to foreign users has to be reduced," Dutch Security and Justice Minister Ivo Opstelten said in a letter to parliament.

"Drug use by minors will be strongly discouraged and in particular, vulnerable young people will be protected against drug use," the minister added.

The new rules, which will first take effect in the south and gradually be extended countrywide, limit sales of cannabis to residents of the Netherlands who must enroll as members of a coffee shop, the minister said.

The rules will come into effect from January 1, 2012, but will not be enforced until May 1, starting in the three southern provinces where drug tourism is most common and regarded as a problem by many local residents.

The rest of the country, including Amsterdam, whose drugs scene is a tourist magnet, will enforce the new rules from January 1, 2013.

From that year onwards, a coffee shop can have a maximum of 2,000 members.

The Dutch government, whose push for a stricter drugs policy is led by the Christian Democrats party, will forbid any coffee shops within 350 m (yards) of a school, with effect from 2014.

The government in October launched a plan to ban what it considered to be highly potent forms of cannabis -- known as "skunk" -- placing these in the same category as hard drugs such as heroin or cocaine.

(Reporting by Gilbert Kreijger)


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Dentists Could Fill Gap in Health Care, Study Says

THURSDAY, Dec. 15 (HealthDay News) -- Nearly 20 million Americans who see a dentist at least once a year don't see a doctor or other general health care provider, which suggests that dentists could screen these people for systemic health disorders, such as high blood pressure, diabetes and heart disease, a new study says.

New York University investigators analyzed data from more than 31,200 adults who took part in the 2008 U.S. National Health Interview Survey.

Based on those findings, the researchers determined that 26 percent of U.S. children did not see a general health care provider (physician, physician assistant, nurse, nurse practitioner), but more than one-third (7 million) of those children did visit a dentist at least once in 2008.

One-quarter of U.S. adults did not visit a general health care provider, but nearly a fourth (13 million) of those adults visited a dentist at least once in 2008.

Eighty-five percent of the adults and 93 percent of the children had health insurance. This suggests that many of those who did not see a general health care provider may have had access to general care, but chose not to seek it, the researchers said.

They said their findings suggest that dentists could play an important role in identifying health problems that might otherwise go undetected in a large segment of the population.

"For these and other individuals, dental professionals are in a key position to assess and detect oral signs and symptoms of systemic health disorders that may otherwise go unnoticed, and to refer patients for follow-up care," Dr. Shiela Strauss, an associate professor of nursing at the New York University College of Nursing and co-director of the statistics and data management core for NYU's Colleges of Nursing and Dentistry, said in an NYU news release.

She explained that dentists and dental hygienists can take a patient's health history, check blood pressure and use direct clinical observation and X-rays to detect risk for systemic health disorders.

The study was published Dec. 15 in the American Journal of Public Health.

More information

The U.S. Centers for Disease Control and Prevention has more about regular health check-ups.


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Robotic Therapy May Help Some Stroke Survivors Walk

THURSDAY, Dec. 15 (HealthDay News) -- Using a robotic assist system along with conventional rehabilitation therapy boosts the walking ability of people who've suffered a severe stroke, Italian researchers say.

They tracked 48 stroke survivors who were unable to walk at the start of the study. Half of the patients underwent conventional gait rehabilitation and half had conventional rehab plus robotic-assisted gait training for several months.

The robotic devices are therapist-controlled electromechanical platforms attached to the patient's feet. The therapist assesses the patient's status and then progressively sets the walking pace and bearing weight.

The patients' mobility was evaluated while in hospital, at discharge and then again two years later.

Among the patients in the robotic device-assisted group, only those with the greatest degree of disability showed improvement, according to the study published in the Dec. 15 issue of the journal Stroke.

"After two years, five times more patients who underwent robotic assistance training were able to walk without assistance, but only the most severely impaired," lead researcher Dr. Giovanni Morone, a physiatrist specialist and temporary assistant professor at the Santa Lucia Foundation, Institute for Research Hospitalization and Health Care in Rome, said in a journal news release.

"In others it seemed to make little difference, so the patient selection for this type of treatment is most important," he noted.

Some studies have found that robotic assistance can help improve stroke patients' mobility for six months, while others have found that it's equal to or less effective than having patients walk outside, the researchers pointed out in the news release.

"It could be time to change the research question from whether or not robotic-assisted walking training is effective, to who will benefit the most," Morone said. "Doctors need to select the right patients and remember that this is an adjunct [added] to traditional gait training."

One U.S. expert agreed that the role of robotics in stroke recovery remains unclear.

"While exciting, there is still much work to be done in establishing the effectiveness of robotics," said Dr. Craig Rosenberg, chairman of the department of rehabilitation medicine, at North Shore-LIJ Southside Hospital in Bay Shore, NY. "The cost of robotics remains high and there is limited availability to the stroke- and brain-injured population," he added.

Rosenberg also noted that "robotic technology is typically available only through research studies at this time."

More information

The National Stroke Association has more about stroke recovery and rehabilitation.


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NYC Sees Drop in Child Obesity; Can Other Cities Do Same?

THURSDAY, Dec. 15 (HealthDay News) -- In what might serve as a hopeful sign for all children in the United States, a new study finds that obesity rates among New York City's school children have dropped slightly in the past five years, particularly among the youngest.

Although the absolute decline in the obesity rate is only 1.2 percent, it's still the largest drop seen yet in any major U.S. city, the researchers noted, and many of the programs that New York City health and education officials implemented to combat rising childhood obesity rates are being tried in other parts of the country.

"This is really good news, but there are still one in five children in grades K-8 who are obese, which is still a huge number of children," said study author Magdalena Berger, a city research scientist in the New York City Department of Health and Mental Hygiene. "We are on the right track, but we still have a very long way to go."

Obesity among children has been increasing since the 1970s, Berger said. "In the last decade, nationally, we have seen a leveling off of obesity, but this is the first well-documented decline in obesity among children that we have seen."

The drop in obesity is statistically significant, because of the large number of children in New York City's public schools, Berger said. "Whether or not it's actually meaningful is another question," she added.

"I think it's meaningful in the sense that it's not going up, and that's good news, it's not staying stable, and that's good news," Berger said. "I would characterize this as a slow sustained drop over five years; it's not a dramatic drop."

Although the reasons for the decline in obesity among these school children isn't clear, Berger speculated that policies implemented by the New York City departments of health and education, along with more public awareness of the problem, may have played a role.

Study co-author Cathy Nonas, director of Physical Activity and Nutrition Programs in New York City's Department of Health and Mental Hygiene, said several changes in city schools probably contributed to the drop in obesity rates.

"There are significant changes in school food," she said. "There is no whole milk in the schools anymore, it's only 1 percent and the chocolate milk is skim and low sugar," she said. "That saved 4.5 billion calories, just by making that change."

In addition, food served in schools has reduced fat and no trans fats and reduced salt, and the level of fiber has been increased, Nonas said. Drinks and snack foods sold in schools are also healthier, she said. Similar policies were also instituted in early child-care centers, she added.

Also, the city has trained K-5 teachers on how to increase physical activity in the classroom, Nonas said.

"It's a layering effect" that all contributed to reducing obesity rates, Nonas believes. These and similar policies are being implemented throughout the country, she noted.

The report was published in the Dec. 16 issue of the U.S. Centers for Diseases Control and Prevention's Morbidity and Mortality Weekly Report.

For the study, Berger's team used data on the more than 900,000 children in kindergarten to eighth grade in New York City public schools. The city's school system collects fitness data on these students every year, Berger said.

The researchers found the obesity for these children, aged 5 through 14, dropped from 21.9 percent in 2006-07 to 20.7 percent in 2010-11, a little more than a 1 percent decline among kids overall.

The biggest drop was among children aged 5 to 6, from 20.2 percent in 2006-07 to 18.2 percent in 2010-11, they noted.

These declines in obesity were seen in all race and ethnic groups, the researchers added.

Obesity expert Dr. David L. Katz, director of the Prevention Research Center at Yale University School of Medicine, said that "this report, showing a decline in obesity among New York City school children over the past five years is, to be sure, a glass half full. But I wouldn't get carried away with the celebrations just yet."

The absolute decline in the overall obesity rate is roughly 1 percent in five years, he noted. "At that rate of progress, it would take a century to fully reverse the damage done over the past several decades. The rate of obesity is still over 20 percent, and the gains are uneven."

This is a window to a very small part of a nationwide obesity problem, Katz added. "The resources of New York City may be sufficient to produce some good news, but that is not generalizable. We have a long way to go, and will need to build diligently on these modest gains to get there," he said.

"Obesity is still a major health issue in children," Dr. Achiau Ludomirsky, chief of pediatric cardiology at NYU Langone Medical Center, New York City, added in a statement. "We can definitely see that the decline in obesity among [New York City] school children is the result of early intervention for better diet, opportunity for physical fitness and the education of students and parents. It is a three-tier effect."

What kids eat and learn away from school is also key. "We can't reduce obesity levels without working closely with the families of students to help them offer better diet options at home and limit a child's time in front of the television, computers and video games," Ludomirsky said.

"But we still have a long way to go," he stressed. "If we don't address the childhood obesity epidemic more proactively right now, it will become a major health issue for the next generation of Americans."

More information

For more on childhood obesity, visit the U.S. National Library of Medicine.


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German body questions InterMune drug, shares drop

(Reuters) - Shares of InterMune Inc fell as much as 30 percent on Thursday, after a German advisory body raised questions on the clinical benefits of its lung drug Esbriet, raising concerns about reimbursement for the drug.

The Institute for Quality and Efficiency in Health Care (IQWiG), an independent scientific institute that provides recommendations to the Germany's reimbursement authority, said treatment with Esbriet, also known as pirfenidone, showed no "additional benefit" or effect on the mortality rate or quality of life.

InterMune, in a press statement, said it had a number of important concerns with the methodology applied by the committee, and plans to vigorously challenge the IQWiG assessment during the 90-day review period that has now begun.

Esbriet, which has a so-called "orphan drug" status in Europe, was approved by the European regulatory authorities in March, as a treatment for idiopathic pulmonary fibrosis -- the scarring or thickening of the lungs without a known cause. The company launched the drug in Germany in September.

Orphan drugs are those approved for the treatment of rare medical conditions. Under German law, such drugs are deemed as having an additional benefit, leading IQWiG to assess the Esbriet additional benefit as given "but not quantifiable," the company said.

"As a next step, we will now carefully analyze the IQWiG report and provide a detailed response by January 5, 2012," Markus Leyck Dieken, InterMune's senior vice president and general manager for Germany, said in a statement.

However, the company's shares had already lost a third of their value earlier in the day on media reports about the committee decision. At least three brokerages cut their price targets on the stock saying that the final report, which is expected next year, will likely have an effect on the reimbursement of Esbriet.

"We wonder if other EU countries would wait to price/reimburse the drug until IQWiG's final assessment/potential re-pricing in Germany," Jefferies analyst Eun Yang said in a note to clients. Yang predicts the final decision will not be significantly different from this preliminary one.

Accordingly, the analyst lowered his 2013 Europe Esbriet sales estimates to $51 million from $92 million, while cutting his price target on the stock to $10 from $18.

Brisbane, California-based InterMune is studying the drug in a late-stage trial for approval in the United States, after the country's health regulators asked for a new efficacy data on it.

Brean Murray Carret analyst Brian Skorney, who has a price target of $42 on the stock, said the FDA's decision on U.S. approval would not be influenced by the German body's assessment.

Earlier on Thursday, Goldman Sachs cut its sales expectations for Esbriet on an analysis of the drug's launch, calling the European launch "staggered." The brokerage reduced its price target on the stock to $22 from $29.

InterMune shares closed down more than 30 percent at $12.74 on Nasdaq, after touching a 52-week low of $12.60 earlier on Thursday.

(Reporting by Vidya L Nathan in Bangalore; Editing by Sriraj Kalluvila and Richard Chang)


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Study Identifies Strategies to Reduce Maternity, Child Deaths

The World Health Organization released findings from a three-year study on interventions to prevent death in mothers during pregnancy and childbirth and also deaths in children under five. Here are study results and how they affect parents.

Maternal and child mortality

According to the Partnership for Maternal, Newborn and Child Health (PMNCH) 358,000 women die each year during pregnancy or in childbirth. 7.6 million children die before their fifth birthday. Most maternal deaths occur during or right after childbirth. The most common causes are bleeding, high blood pressure, difficult labor and infection. 40 percent of under-age-5 deaths occur within 28 days of birth. 50 percent of the infant deaths happen during the first 24 hours and three-quarters in the first week of life. Leading causes of infant mortality are preterm birth, severe infections and asphyxia.

WHO study goals

The goal of the study was to determine what strategies were working best, were the best use of funds allocations and could be implemented most successfully in hospitals, birthing centers and by midwives in local communities. Study author and WHO Department of Maternal, Newborn, Child and Adolescent Health director Elizabeth Mason says what's new about the study is " putting together information in a different way and building consensus among physicians, scientists and professional organizations to lay out an evidence-based path to help women before, during and after birth and their children. "

WHO study details

WHO, in partnership with Aga Kahn University (AKU) in Pakistan and PMNCH, conducted a far-reaching global study which explored over 50,000 scholarly papers, from 440 PMNCH partners covering 142 different health interventions. The criteria for intervention took into consideration differing maternal and parent profiles: they looked for strategies that could be adapted to whatever families had available in treatment, from local midwife to large hospital.

Study findings

Study leader and chair of AKU's Women and Child Health Zulfiqar Bhutta says, "What came back was a hodge-podge. PMNCH partners had very different ideas of what should be undertaken." Of the various strategies, WHO identified 56 techniques that could be combined into "packages" of birthing care. WHO organized the 56 techniques into five main thrusts of mother-and-child care.

Key interventions for mothers

Anemia, they determined was a dominant factor in maternal death, so getting iron via nutrition and supplements to mothers during pregnancy and childbirth is crucial. Strategies to prevent post-partum hemorrhaging was also addressed.

Key interventions for infants and children

WHO found that immediate thermal care for newborns was essential. They recommend techniques like Kangaroo Mother Care (keeping the infant close to the mother's body and encouraging breast feeding). Other strategies include improving feeding support for LBW (low birth weight) and preterm babies. LBW is linked to several issue in childhood and even adulthood, Medscape says. WHO says pneumonia is a leading cause in child death, so the study recommended antibiotic therapy.

Marilisa Kinney Sachteleben writes about parenting from 23 years raising four children and 25 years teaching K-8, special needs, adult education and homeschool.


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Full ban on driver calls could be tough to enforce

WEST PALM BEACH, Fla. (AP) — A driver in the next lane is moving his lips. Is he on a hands-free cellphone? Talking to someone in the car? To himself? Singing along to the radio?

If lawmakers follow the advice of a federal board, police officers will have to start figuring that out — somehow.

The National Transportation Safety Board said this week that drivers should not only be barred from using hand-held cellphones, as they are in several states, but also from using hands-free devices. No more "Sorry, I'm stuck in traffic" calls, or virtually any other cellphone chatter behind the wheel.

Though no state has yet implemented such restrictive rules, the NTSB's recommendations carry weight that could place such language into future laws, or motivate the federal government to cut funding to states that don't follow suit.

Many of the men and women patrolling the nation's streets and highways wonder how they would sort the criminally chatty from the legally chatty.

"It would be almost impossible to determine if someone was talking on a phone or exercising their vocal cords," said Capt. Donald Melanson of the West Hartford, Conn., police department, which took part in a national pilot program aimed at cracking down on drivers' cellphone use. "That would be much more difficult to enforce, almost to the point where it would be impossible."

Officer Tom Nichols of the Port St. Lucie, Fla., police said a law written like the NTSB suggests would be difficult to enforce because so many variables would be at play.

"If you identify someone who has a hands-free set hooked up to their ear that doesn't mean they are talking on the phone," he said. "They could be talking to a passenger. They could be talking to a child in the back. They could be singing."

Police could end up turning to technology for help. They might even end up with the cellphone equivalent of a radar speed gun.

Fred Mannering, a Purdue University civil engineering professor who is associate director of the Center for Road Safety, said that since all cellphones emit signals, a simple Bluetooth detection device could spot them.

Computers are already common in patrol cars, and Mannering said a relatively cheap add-on could fit them to track cellphone signals.

"It would be really easy for police to have a computer on board and pick up those signals," Mannering said, "but it is sort of Big Brother."

The NTSB's proposal, announced Tuesday as a unanimous recommendation of its five-member board, urges all states to impose total bans except for emergencies. It cited deadly crashes caused by distracted drivers across the country, and noted that many studies have shown that hands-free cellphones are often as unsafe as hand-held devices.

The recommendation poses an astounding number of questions. What about chauffeurs and traveling salesmen who spend their entire day on the road? And roadside Amber Alert and Silver Alert notifications that implore drivers to call in if they spot a specific vehicle? What comes of phone lines dedicated to those "How's My Driving?" signs on trucks? How will you let someone know you're stuck in traffic?

Joe Schwieterman, a DePaul University professor who studies people's use of technology while traveling, said he can't envision a law so restrictive ever hitting the books because phone use has become commonplace for drivers. He called such an approach "draconian" and said that if such a law were passed, the public would despise it as "imperial overreach," then ignore it.

"It's a little like speeding laws where it will become just culturally acceptable to violate," he said. He said a no-call law would be followed only if violations carried stiff penalties like those for drunken driving.

Lewis Katz, a law professor at Case Western Reserve University, said a nationwide ban on using cellphones while driving would be wildly unpopular, and likely the target of legal challenges. But he believed such a law, and the methods police might use to enforce it, ultimately would be deemed as constitutional as seatbelt enforcement.

"I'm sure that it would be challenged on all sorts of constitutional grounds, including free speech," he said in a phone call from his car. "But it seems to me that it doesn't in any way infringe on any constitutional rights. It's a simple safety issue."

Whether the NTSB's recommendations will motivate decision-makers remains to be seen, but they have certainly caught their attention.

Transportation Secretary Ray LaHood, who has made combating distracted driving the signature issue of his tenure, stopped short of an endorsement. His department is separate from the NTSB.

"My focus is going to be on preaching to people: Take personal responsibility. Put your cellphone and your texting device in the glove compartment when you get behind the wheel of a car," LaHood told reporters at a news conference in Chicago. "You can't drive safely when you have your hand on a cellphone and are trying to drive a 4,000- 5,000 pound vehicle."

Florida House Speaker Dean Cannon, a Republican, said he was wary. His state is among those that have resisted passing laws restricting drivers' cellphone use.

Cannon said future technological advances may prove more effective than legislation at addressing driver distraction issues. As an example, he cited his new iPhone, which can make phone calls and send text messages via voice command.

"In these attempts to try and prevent every bad thing from happening," he said, "it's all too easy to overly restrict personal freedoms and individual rights and responsibilities."

Sheriff Ric Bradshaw, the top law enforcement official in Palm Beach County, Fla., said that if lawmakers take the NTSB's suggestions to heart, they should address all manner of distracted driving.

"I see women putting makeup on. I see a guy with an electric shaver. I see one woman with a newspaper. I see a guy with a dog in his hands. All of those are worse than texting," he said.

Monique Bond, a spokeswoman for the Illinois State Police, said training would be key to enforcing any ban. Officers are already looking for unbuckled seat belts and swerving drivers; they'd have to add to their mental checklists.

"It's something that is not insurmountable," Bond said. "How you're going to spot it, or how you're going to look for it — you have to acclimate the troops and acclimate the operations as to how to do this."

Chief Walter McNeil of Quincy, Fla., president of the International Association of Chiefs of Police, said enforcement of a total ban would be difficult, but that distracted driving needs to be addressed.

"We certainly need to deal with the overall problem with distracted drivers, and getting some level of uniformity in how we enforce that would be helpful," he said.

___

Associated Press writer Dave Collins in Hartford, Conn., contributed to this report.


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Elite athletes at greater risk for arthritis: study

(Reuters) - Elite male athletes who participate in high-contact sports such as football, soccer and rugby have a higher risk of developing knee and hip osteoarthritis than men who exercise little or not at all, a Swedish study found.

There was a doubled risk in soccer and handball players, and a tripled risk in ice hockey players, added the researchers, whose study was published in the American Journal of Sports Medicine.

Osteoarthritis, also called "wear and tear" arthritis, occurs when the cartilage cushioning the joints wears down. That allows bones to rub together, which can cause pain, swelling and limited range of motion.

"Hip and knee osteoarthritis ... are more commonly found in former male elite athletes than expected," wrote co-author Magnus Tveit at Lund University in Sweden.

"A previous knee injury is associated with knee osteoarthritis in former impact athletes but not in nonimpact athletes."

The study included more than 700 retired Swedish athletes aged 50 to 93 who had played professional and Olympic level sports, and nearly 1,400 men of the same age who exercised a little or not at all.

The group of retired athletes included men involved in high-contact sports such as soccer and hockey, and those who participated in non-contact sports like running, swimming and cycling.

The risk of having hip or knee arthritis was 85 percent higher in elite athletes. In athletes who had had joint surgery, the risk more than doubled.

The risk for those who got little to no exercise was 19 percent.

"Regular exercise is important to health and well being, but certain kinds of exercise expose you to greater risk of injury," said Joseph Buckwalter, who studies osteoarthritis and sports medicine at the University of Iowa and was not involved in the study.

"Elite athletes engage in challenging, physically demanding sports, so they're at higher risk of joint injuries and repetitive joint injuries."

Though the study found little impact on younger or weekend athletes, there are a few lessons for some, added Tveit.

"If you're an overweight, middle-aged runner who wants to run at an intense level, there are better ways of staying in shape without risking a knee injury," he wrote in an email.

Experts agreed that physical activity regardless of the type of sport had health benefits that outweigh the risk of arthritis, and recommended sports with less risk of injury such as swimming, cycling, moderate running and yoga. SOURCE: http://bit.ly/uSjtXd

(Reporting from New York by Linda Thrasybule at Reuters Health; Editing by Elaine Lies and Robert Birsel)


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Sense of Smell Helped Separate Humans From Neanderthals

FRIDAY, Dec. 16 (HealthDay News) -- Modern humans -- Homo sapiens -- have a better sense of smell than their extinct Neanderthal cousins, which may be one reason why one thrived while the other died out, according to scientists.

Brain size is the same in both species, but differences in brain shape may indicate differences in brain organization that may be linked to behavior and cognition, which includes skills such as memory, problem solving, attention and producing and understanding language.

The international team of researchers used high-end imaging techniques to assess the internal structure of fossil H. sapiens and Neanderthal skulls. The scans revealed that modern humans have larger temporal lobes (involved in memory, language and social function) and 12 percent larger olfactory bulbs (involved in the sense of smell) than Neanderthals.

While other senses go through a number of brain filters, the sense of smell is directly connected to regions of the brain that process emotions, memory, fear, motivation, pleasure and sexual attraction.

"The sense of smell is directly linked to memories to an extent that no other sense is. This explains why smells immediately incite strong emotions concerning past events and also strong feelings about people," Katerina Harvati, of the University of Tubingen and the Senckenberg Center for Human Evolution and Palaeoecology in Germany, said in a university news release.

The better sense of smell in H. sapiens may be related to the evolution of social functions such as recognition of related people, enhanced family relations, group cohesion and social learning, Harvati and colleagues suggested.

"Although traditionally olfaction in primates and humans has been considered a less important sense, our study reevaluates its potential significance for human evolution, and particularly for the social evolution of our own species, Homo sapiens," they concluded.

The study appeared Dec. 13 in the online journal Nature Communications.

More information

The Social Issues Research Center has more about the human sense of smell.


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Christmas Trees and Trappings Can Fan Fire Risk

SUNDAY, Dec. 18 (HealthDay News) -- The risk of burns increases over the holiday season because people are cooking more, putting up potentially flammable decorations and using fireplaces and candles.

"We see a significant increase in burn patients between Thanksgiving and Christmas. Your holiday, which should be full of joy and celebration, can quickly turn tragic," Dr. Jeff Guy, director of Vanderbilt Regional Burn Center in Nashville, Tenn., said in a Vanderbilt University news release.

Many of these injuries are easily preventable if people are cautious and eliminate potential dangers that could lead to burns.

Guy outlined a number of ways to prevent burns and have a safe holiday season.

Staying in the kitchen and being attentive while cooking can prevent most cooking fires. Keep pot holders, wooden utensils, towels, food packaging and anything else that can catch fire away from the stovetop.

Use turkey fryers outdoors and keep them a safe distance from the building. Never overfill a fryer with oil and never leave it unattended.

When you buy an artificial Christmas tree, select one with a "fire resistant" label. When buying a real tree, check for freshness. It should be green, the needles should be hard to pull, the trunk should be sticky with resin and the tree shouldn't lose many needles when it's hit.

Keep fresh trees away from fireplaces and radiators and keep the tree stand filled with water. A well-watered tree is usually safe but it can take just a few seconds for a dry tree to be ablaze, Guy said.

Check new and old sets of Christmas lights for broken or cracked sockets, frayed wires or loose connections, and discard damaged sets. Don't overload extension cords and never use electric lights on a metallic tree.

Don't burn wrapping paper in the fireplace, because it can ignite suddenly and burn intensely. Place candles away from trees and other decorations and in locations where they can't be knocked over. Never leave candles unattended.

More information

Health Canada offers holiday safety tips.


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Olympus offices to be raided this week: report

TOKYO (Reuters) - Tokyo police, prosecutors and the securities watchdog will likely launch a raid on the offices of disgraced Olympus Corp this week on suspicion the company falsified financial accounts, Kyodo News has reported, citing investigative sources.

The raid has been expected to follow a re-statement of Olympus's financial records, which were presented on December 14 and revealed a $1.1 billion dent in its balance sheet after a 13-year fraud.

The planned search by Tokyo prosecutors, likely to be conducted jointly with police and the Securities and Exchange Surveillance Commission, follows mounting allegations that former Olympus executives led the accounting fraud, Kyodo said.

Kyodo cited the sources as saying prosecutors hoped to build cases by the end of March against former Chairman and President Tsuyoshi Kikukawa, former corporate auditor Hideo Yamada, and former Executive Vice President Hisashi Mori.

Former employees at major securities companies could also be implicated for allegedly abetting the fraud, it added.

Olympus, a maker of cameras and medical equipment, spent hundreds of millions of dollars on dubious M&A deals as part of an attempt to hide investment losses from investors for 13 years.

The company last week filed five years worth of corrected financial statements, plus overdue first-half results, just hours before a Tokyo Stock Exchange deadline that could have seen it automatically delisted.

(Reporting by Chang-Ran Kim; Editing by Paul Tait)


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Hand, foot, mouth disease kills 156 in Vietnam

Vietnam says an outbreak of hand, foot and mouth disease has killed 156 people, mostly children, and sickened more than 96,000 through late November.


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Drug Users With HIV at Much Higher Overdose Risk

FRIDAY, Dec. 16 (HealthDay News) -- HIV-infected drug users are 74 percent more likely to have an overdose than those without HIV, a new evidence review finds.

Behavioral and biological factors may be among the reasons for this increased risk, according to the Rhode Island Hospital researchers. Drug overdose is a frequent cause of non-AIDS death among people with HIV.

The link between HIV infection and drug use is well documented, but the association between HIV and overdose has received less attention and was the focus of this study, which involved a review of 24 previous studies.

"Over the past 30 years, we have made impressive strides in caring for and prolonging the lives of people with HIV. Our study found that premature death by overdose is an issue that affects people with HIV disproportionately," study leader Traci Green, a researcher with Rhode Island Hospital and the Lifespan/Tufts/Brown Center for AIDS Research, said in a hospital news release.

"It is not entirely clear why the risk is greater, and few studies have endeavored to figure out why this might be happening," she added.

Biological factors may include clinical status, weakened immune systems, opportunistic infections and poorer physical health among HIV-infected drug users. Some research has suggested that hepatitis C infection and other conditions that affect metabolic ability may also increase the risk of overdose, according to the release.

Behavioral factors -- such as high-risk lifestyles and an increased rate of psychiatric conditions -- may also contribute to the higher risk of overdose among HIV-infected drug users, Green said.

Other possible factors could include homelessness and poverty, and poor access to medications and therapy used to treat opioid dependence, she suggested. Many HIV patients take opioid painkiller drugs as part of their treatment, while others use illegal opioids.

The study appears online in advance of print in the journal AIDS.

"Bringing overdose awareness and prevention into the HIV care setting is critical to reducing overdose deaths," Green said.

"Health care providers who treat HIV-infected patients with a history of substance abuse or who are taking opioid medications should consider counseling patients on how to reduce their risk of overdose. They may also consider prescribing naloxone (Narcan) to patients, or offering a referral to MAT (medication-assisted therapy) to reduce the risk of overdose," she advised.

Naloxone is a prescription medication that reverses an opioid overdose and has no abuse potential.

More information

The New Mexico AIDS Education and Training Center has more about recreational drugs and HIV.


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Factbox: How the U.S. Preventive Services Task Force works

WASHINGTON (Reuters) - The U.S. Preventive Services Task Force is an influential body of health advisers backed by the government to routinely weigh the benefits and risks of early screening for disease.

For much of its 27-year history, the panel has helped persuade Americans to get screened early, but more recently it has come under fire for advice to limit testing that may do more harm than good for healthy people.

Here are some facts about the panel:

MEMBERS

The task force is made up of 16 health experts: 13 doctors, two registered nurses and one academic. Put together, they have expertise in treating patients at all stages of life and from very diverse cultural and social backgrounds.

The panel members volunteer on average four to six hours a week in addition to their day jobs at hospitals and universities. They meet in person three times a year for two days. For those meetings, they receive travel reimbursement and about $150 a day in honorarium.

The task force members are appointed to four-year terms with an option for an extension for another one or two years. Virtually anybody can nominate new panel candidates through this website: http://www.ahrq.gov/clinic/tfnominfo.htm.

LETTER GRADE RECOMMENDATIONS ON SCREENINGS

There are five:

A: benefits substantially outweigh harms and the panel recommends the service.

B: benefits moderately outweigh harms and the panel recommends the service.

C: benefits are small and the decision about the service should be carefully weighed by patients with their doctors.

D: harms outweigh or negate benefits and the panel does not recommend the service.

I: evidence is insufficient for the panel to make a call.

Since controversy over its mammography recommendation, the task force has struggled to find better standard language to go with the "C" recommendation. A final statement on counseling for physical activity and healthy diet, expected soon, will likely give the first peek at the new wording.

HOW OFTEN DOES THE PANEL RECONSIDER ITS RECOMMENDATIONS?

The panel aims to refresh recommendations every five years, or whenever new evidence emerges to warrant a reevaluation.

HOW DOES THE PANEL'S REVIEW PROCESS WORK?

The task force and its supporting Agency for Healthcare Research and Quality (AHRQ) -- part of the Department of Health and Human Services -- draft questions for researchers to answer about a particular screening and its effects, based on the most recent clinical evidence.

If the standing recommendation is unlikely to change, the research may be done internally by AHRQ officers. More often, however, the panel involves outside researchers from evidence-based practice centers around the country. They analyze all trials and studies on the subject, weed out lower-quality studies, crunch data and write a journal article.

Before being published in the Annals of Internal Medicine, the articles are peer-reviewed. In more controversial cases the panel specifically seeks out peer reviewers to represent varying opinions.

The researchers then present the data to the panel, which has to reach a supermajority for a vote on any recommendation. If some members have serious disagreements, the data can be sent back for more research.

(Reporting by Alina Selyukh)


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US approves first heart pump for children

Vietnam says an outbreak of hand, foot and mouth disease has killed 156 people, mostly children, and sickened more than 96,000 through late November.


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Analysis: Deficit may be biggest threat to healthcare reforms

WASHINGTON (Reuters) - A mounting U.S. deficit could pose a much greater threat to the survival of President Barack Obama's healthcare reforms than either the Supreme Court or 2012 elections.

Many health experts say innovations in delivering medical care and the creation of state health insurance exchanges for extending coverage to the uninsured are likely to continue in some form even if Obama's 2010 Patient Protection and Affordable Care Act is struck down or repealed.

But former top healthcare policymakers from Democratic and Republican administrations warn that some of the most promising measures for controlling costs, while improving quality and access to care, could run aground as early as 2013 if a new Congress and administration respond to the fiscal pressures with arbitrary spending cuts.

"If the plan is what's on the table now, which is cut, cut, cut - shift the burden to poor people and taxpayers, take away benefits, take away Medicaid coverage - things will get worse," said Dr. Don Berwick, who left his temporary post as Obama's head of Medicare and Medicaid this month after Republicans blocked his Senate confirmation.

The Affordable Care Act is designed mainly to extend healthcare coverage to more than 30 million uninsured Americans by expanding Medicaid for the poor and establishing state exchanges where people with low incomes who do not qualify for Medicaid can buy subsidized private insurance.

It also calls for innovations that could guide America's $2.6 trillion healthcare system, the world's most expensive, toward incentives to contain costs.

The law faces fierce Republican opposition and is heading into a period of unprecedented turmoil.

Next spring the Supreme Court is expected to rule on the constitutionality of the individual mandate, the law's lynchpin provision that requires all Americans to buy insurance. Months later, voters will deliver another verdict by deciding whether Republicans or Democrats control the White House and Congress.

Current and former healthcare officials have great hopes for changes that reward doctors and other providers for how well patients progress rather than compensating them according to the number of tests and procedures they perform.

For a panel discussion on the subject moderated by Reuters at Harvard School of Public Health, go to: www.ForumHSPH.org

"These reforms really have the potential for a longer term impact on healthcare costs," said Dr. Mark McClellan, who oversaw Medicare, Medicaid and the Food and Drug Administration under President George W. Bush.

GAINING MOMENTUM

Some innovations, like "bundled payments," set cost targets for specific conditions that teams of doctors must meet. Others reward healthcare providers for keeping patients healthy or for delivering successful outcomes while saving money.

The innovations were already taking hold in the private market before Obama signed the healthcare bill into law in March 2010.

Their momentum has gained pace sharply across the United States as a result of the law's efforts to apply them to Medicare and Medicaid, which combined spend about $900 billion annually to provide care to 100 million beneficiaries.

The year-old Center for Medicare and Medicaid Innovation has about two dozen innovation models that it intends to develop with private partners over the next few years.

Experts say innovations in delivering care are durable because they offer providers a way to cope with growing cost pressure from employers who sponsor health insurance and from government agencies forced to cut spending.

"This is a response to market realities, not just reformist interests," said Don Moran, a Washington-based healthcare consultant who served in President Ronald Reagan's Office of Management and Budget.

The climate for innovation could change dramatically after Election Day in November if Washington responds to deficits with across-the-board cuts to Medicare and Medicaid that reinforce the traditional fee-for-service approach to healthcare.

Innovations are vulnerable because they have yet to established a cost-cutting track record to which the bipartisan Congressional Budget Office can assign tangible dollar values for deficit reduction.

Gail Wilensky, who headed Medicare and Medicaid under President George H.W. Bush, worries that Congress will opt for the standard practice of cutting payments to doctors and other healthcare providers, who may react by dropping Medicare patients.

"That's the only thing Congress will get credit for and so that's what they'll do. We know this is not our future if we want to do well by our seniors," she said at the Harvard School of Public Health forum on Friday.

Some analysts say deficit pressures could encourage the Obama administration to delay segments of the healthcare law, including state health insurance exchanges and the requirement for each individual citizen to have health insurance.

Such a move could save tens of billions of dollars in government spending, while giving state and federal officials more time to set up exchanges that have taken shape slowly amid uncertainties posed by the Supreme Court case and the election.

An administration official said there are no plans to delay the law's implementation. "That idea has never been discussed and is not under consideration," the official said.

The election also is unlikely to decide the law's fate unless Obama loses re-election, according to analysts who say Congress is unlikely to overcome partisan gridlock even if Republicans eke out a slim majority in the Senate.

McClellan said sections of the law including state insurance exchanges could go forward even if the individual mandate were overturned in court, repealed after the election or weakened by political and budgetary pressures.

Instead of a legal requirement for purchasing insurance, McClellan said the government could design effective voluntary rules that encourage people to participate in exchanges

.

He said an obvious model would be Medicare Part D, the prescription drug benefit that offers rewards for people who enroll early and penalties for those who show up late.

McClellan acknowledged that state exchanges would not be as robust without the individual mandate but said that fact could result in deficit savings.

The administration official said there are currently no plans or conversations taking place about using Part D enrollment restrictions in place of the individual mandate.

(Reporting By David Morgan; Editing by Xavier Briand)


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Are You Headed for a Holiday Breakdown?


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Govt to adopt strict new limits on chimp research

WASHINGTON (AP) — Days in the laboratory are numbered for chimpanzees, humans' closest relative.

Chimps paved astronauts' way into space and were vital in creating some important medicines. But the government said Thursday that science has advanced enough that from now on, chimpanzees essentially should be a last resort in medical research — a move that puts the United States more in line with the rest of the world.

Chimps' similarity with people "demands special consideration and respect," said Dr. Francis Collins, director of the National Institutes of Health.

His move came after the prestigious Institute of Medicine declared that most use of chimpanzees for invasive medical research no longer can be justified — and that strict new limits should determine which experiments are important enough to outweigh the moral cost of involving this species that is so like us.

"The bar is very high," said bioethicist Jeffrey Kahn of Johns Hopkins University, who led the institute panel.

The group stopped short of recommending an outright ban, saying a handful of research projects today might still require chimps — but more importantly, that the animals might be required in the future as new diseases evolve and emerge.

Animal welfare groups welcomed the change but continue to push for Congress to pass legislation that would go a step further and phase out all invasive chimp research.

"Chimpanzees have provided limited value in research settings, and now alternative methods have been developed that will make their use all but obsolete," said Wayne Pacelle, president of the Humane Society of the United States.

But some scientists say it's not that big a change because chimp studies already were dwindling fast as researchers turned to less costly and ethically charged alternatives.

"The use of a chimpanzee in biomedical research is the rare exception," said Dr. Thomas Rowell, who directs Louisiana's New Iberia Research Center, one of five research centers that houses chimps and other primate species used in both government- and privately financed studies.

It's not clear exactly how many of the nation's 937 research chimps — 612 of them owned by the NIH — are in the midst of experiments that would be affected by the new standards and could be moved into retirement instead. Most of the chimps are fairly old, as the nation has had a moratorium on breeding since 1995.

But Collins temporarily barred new government-funded studies involving chimps as his agency began implementing the recommended restrictions. Also, a working group will decide whether to phase out about 37 ongoing projects, about half of which Collins said probably don't meet the new standards.

These apes' genetic closeness to humans — the genome is about 99 percent identical to ours — has long caused a quandary, making the animals valuable to medical researchers for nearly a century but also sparking ethical and emotional questions about how they are housed and used.

"They are highly intelligent. They live in complex social settings, and they live for a very long time," said evolutionary anthropologist Anne Pusey of Duke University, who once worked with chimp expert Jane Goodall in Tanzania and manages an archive of Goodall's field data on the animals.

"When you enclose a chimp in a very small cage for 50 years, it really is cruel and unusual, even regardless of whether you're doing invasive things to them," she added.

The U.S. is one of only two countries known to still conduct medical research with chimpanzees; the other is Gabon, in Africa. The European Union essentially banned such research last year.

Thursday's decision was triggered by an uproar last year over the fate of 186 semi-retired research chimps that the NIH, to save money, planned to move from a New Mexico facility to an active research lab in Texas. They are staying put for now.

The Institute of Medicine's investigation found over the past 10 years, the NIH has paid for just 110 projects of any type that involved chimps. Most involved hepatitis C, a liver virus that infects only humans and chimps. Some involved HIV, a disease that scientists now know is better to study in rhesus monkeys. Still others involved comparing the genetics of chimps and humans, or behavioral research examining such things as development and mental health.

The institute recommended two different sets of restrictions. Biomedical research — testing new drugs or giving chimps a disease — should allow using the apes only if studies could not be done on other animals or people themselves, and if foregoing the work would hinder progress against life-threatening or debilitating conditions. The panel said behavioral and genetic research, while less controversial, nonetheless should be limited to studies that provide insights otherwise unattainable, using techniques that minimize any pain or distress.

The institute combed research files to see what types of projects would fit those strict criteria — and could come up with only a handful, such as a possible need to test vaccines against hepatitis C in the animals. But the panel concluded chimps aren't needed to study cancer or a host of other diseases or even to test most drugs.

The standards wouldn't automatically apply to privately funded pharmaceutical research, although the industry, too, is shifting away from use of chimps. One drug company, GlaxoSmithKline, adopted an official policy ending its use of great apes, including chimpanzees, in research.


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